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Six steps of uremia diagnosis
Uremia is the end of the performance of a variety of nephropathy, because of its perse manifestations, the diagnosis of uremia is relatively difficult, many patients are not due to timely and correct diagnosis and missed the opportunity to treat. What is the diagnosis of uremia, and how to diagnose uremia?. Uremia diagnosis from six aspects to prevent misdiagnosis and missed diagnosis.
1, the history and symptoms of uremia diagnosis
Uremia diagnosis from the past history. The past have all kinds of glomerulonephritis, pyelonephritis, hypertension, diabetes and gout history. Early often have anorexia, nausea and vomiting, headache, fatigue and nocturia, gradually oliguria, edema or high blood pressure. Most of the disease population odor, oral mucosa ulcer, nasal bleeding or hemorrhage of digestive tract, can be difficult to concentrate attention, unresponsive, numbness, drowsiness or restlessness, neuropsychiatric symptoms, severe incontinence and even coma; chest tightness, shortness of breath, precordial discomfort, prompt uremic cardiomyopathy, cough, sputum or hemoptysis, night not supine, prompting pulmonary edema or uremic pneumonia; a few patients with chest tightness, persistent chest pain, or accompanied by fever, may for pericardial effusion; such as skin itching, pain or muscle twitching, even walking inconvenience, suggesting that concurrent secondary hyperparathyroidism beside the hyperactivity or renal osteodystrophy; patients susceptible to infections, such as respiratory tract infection, urinary tract infection or skin infections.
2, the diagnosis of uremia physical examination should pay attention to
The majority of high blood pressure, anemia appearance or dark complexion, facial or lower extremity edema. A mental abnormality, local or systemic bleeding, rapid shallow breathing or orthopnea, jugular venous, lung wet rales, heart boundary expanding, pleural or pericardial friction sound, heart rate or rhythm changes, and other signs of hepatomegaly ascites.
3, the laboratory diagnosis of uremia
(1) urine routine:
The specific gravity of urine was decreased or fixed, and urine protein was positive.
The decrease of hemoglobin and red blood cell count, hematocrit and reticulocyte count decreased, and the number of three cell lines decreased in some patients.
(3) biochemical examination:
GFR50 ~ 80ml/min, blood urea nitrogen and creatinine was normal, renal insufficiency compensatory period; GFR50 ~ 20ml/min, 186 ~ 442 mol/L of serum creatinine, urea nitrogen more than 7.1mmol/L for renal insufficiency decompensation; GFR20 ~ 10ml/min, 451 ~ 707 mol/L of serum creatinine, urea nitrogen of 17.9 ~ 28.6mmol/L for kidney failure period; GFR is less than 10ml/min, serum creatinine was higher than 707 mol/L, the urea nitrogen 28.6mmol/L to end-stage renal failure, uremia is late. Renal failure, often accompanied by low calcium phosphorus, metabolic acidosis, etc..
4, the imaging diagnosis of uremia
B ultrasound showed the renal volume, renal cortical echo enhancement; radionuclide renal dynamic imaging showed decreased glomerular filtration rate and renal excretion dysfunction; radionuclide bone scan showed renal osteodystrophy syndrome; chest X-ray visible pulmonary congestion or pulmonary edema, increased cardiothoracic ratio or pericardial effusion, pleural effusion.
5. Renal biopsy may be helpful in the diagnosis of early chronic renal insufficiency
6, differential diagnosis
When there is no obvious history of kidney disease, abrupt onset should differentiate with acute renal failure. Severe anemia should be identified with digestive tract tumors, blood system diseases. In addition, attention should be paid to the identification of the original disease and the inducing factors, and to determine the degree of renal function damage.
15 common methods of treatment of uremia:
A, kidney transplant some terminal uremia, need to do dialysis treatment for a long time, in their own economic and physical conditions suitable, will choose kidney transplantation. Kidney transplantation is the process by which an organ donor's kidney is transplanted into the patient's body. A possible source of kidney: family, spouse, close friend, or brain dead and who agreed to donate organs. Kidney transplantation (kidney) in a short period of time can bring a better quality of life; but the transplant is a big project, although the current medical technology has been quite good, still need to do a lot of beforehand assessment, in order to improve the probability of successful kidney transplant.
Two, hemodialysis dialysis (dialysis): dialysis is through filtration, selectively exclude certain substances in the blood. That is to say, by artificial means of toxic waste accumulation in the body of patients with uremia, water and salt out, so that the physical condition of the patient back to health. The dialysis two forms: hemodialysis and peritoneal dialysis. Hemodialysis is a special machine to replace the function of the kidney. Peritoneal dialysis is the use of human peritoneal membrane as a filter to remove toxins from the body.
Three, uremia diet therapy
1 limit potassium intake: the accumulation of potassium in the body can cause muscle weakness, severe cases can cause heart failure caused by heart failure.
2 protein restriction: no dialysis, because the kidneys can't produce protein metabolism after discharge of waste, the uremia situation is more serious, therefore, would suggest reduced protein intake; but if dialysis, it should be noted that in dialysis can cause body protein loss, so we must cooperate with the nutritionist's advice, to the body needs to maintain.
3 limit sodium intake: because salt contains a high sodium content, in the body if there is too much sodium in uremia, will cause the body's water retention, resulting in heart failure and aggravate the situation of uremia. But never
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